In the RCT looking at High dose ILE, what factor(s) led the authors to question the idea of Intralipids role in “lipid sink compartment” model?
1) RCT exhibited gradual/modest hemodynamic effects from the use of ILE infusion alone. which contrasts case reports,in which, rapid onset of action is seen when used concurrently with other modalities (pressors, fluids, etc). The hypothesized rapid effects from the intravascular binding of poison through lipid compartment seem to be negated in their study. No solid evidence of entrapment was found when ILE used in isolation.
Petersen KM, Bøgevig S, Petersen TS, Jensen TB, Dalhoff KP, Henriksen T, Poulsen HE, Christensen MB. Hemodynamic Effects of Intravenous, High-Dose Lipid Emulsion With and Without Metoprolol Infusion in Healthy Volunteers: A Randomized Clinical Trial. Clin Pharmacol Ther. 2019 Apr;105(4):1009-1017.
Contributed by: Dawn Sollee, PharmD DABAT & Molly Stott, PharmD on behalf of Florida/USVI Poison Information Center-Jacksonville